Socioeconomic status during early pregnancy may play a large role in future heart health

Jan 19, 2025 Story by: Editor

Research Highlights:

Socioeconomic status during early pregnancy may influence the cardiovascular health of first-time mothers for up to seven years post-pregnancy.

Factors such as education level, income, health insurance, and health literacy contributed to more than half of the long-term disparities in heart health among Black, Hispanic, and white women, a new study reveals.

Note: The findings in this news release are from a research abstract presented at the American Heart Association’s Scientific Sessions 2024 . These findings are preliminary until published in a peer-reviewed journal.

Socioeconomic disparities during early pregnancy may account for a significant portion of cardiovascular health differences among women from various racial and ethnic backgrounds, according to preliminary research to be presented at the American Heart Association’s Scientific Sessions 2024 in Chicago, Nov. 16-18.

The study analyzed data from over 4,000 first-time pregnant individuals, focusing on how social determinants of health impact maternal cardiovascular outcomes up to seven years postpartum.

“Pregnancy can have long-term consequences on women’s cardiovascular health, and it’s an important opportunity to provide preventive care, especially for individuals with cardiovascular risk factors,” said Dr. Xiaoning “Jack” Huang, a research assistant professor at Northwestern University’s Feinberg School of Medicine. “This research adds a further dimension to what is known about what explains the significant racial disparities that exist in cardiovascular health among birthing individuals.”

The study assessed various factors, including demographics (age and ethnicity), socioeconomic status (education, income, health insurance, health literacy), and psychosocial health (resilience, social support, depression, anxiety, and stress) during early pregnancy. Researchers then measured cardiovascular health scores two to seven years postpartum using the American Heart Association’s Life’s Essential 8 metrics , which include BMI, blood pressure, cholesterol, blood sugar, diet, physical activity, sleep health, and smoking status.

Key Findings:

After adjusting for demographic, socioeconomic, and psychosocial factors, white mothers had an average cardiovascular health score 12.2 points higher than Black mothers and 3.3 points higher than Hispanic mothers.

Socioeconomic factors during early pregnancy had the greatest influence on cardiovascular health scores.

When socioeconomic data for Black women was adjusted to match white counterparts, their cardiovascular health score increased by 6.6 points, eliminating over half the gap.

Similarly, adjusting socioeconomic data for Hispanic women aligned their cardiovascular health scores with those of white women.

“Socioeconomic status is very important; however, I am surprised that it appears to explain the majority of the differences in cardiovascular health two to seven years after giving birth,” Huang said. “If in an ideal society we could have similar socioeconomic status across racial-ethnic groups, then most of the disparities in cardiovascular health may be eliminated.”

Policy Implications:

The findings highlight the need for accessible, affordable health care to mitigate socioeconomic disadvantages.

“This data is critically needed,” said Dr. Vesna D. Garovic, an American Heart Association volunteer expert and director of the Mayo Clinic Center for Clinical and Translational Science . “Identifying the role of socioeconomic status in postpartum cardiovascular health provides supporting data to augment affordable preventive postpartum care, such as extending Medicaid postpartum coverage to one year.”

As of October 2024, 47 states and the District of Columbia have expanded Medicaid, offering extended postpartum health coverage to address maternal health disparities.

Garovic added, “Recent trends indicate that the United States is the only developed country with an increasing maternal death rate. Poor care before, during, and after a birth has been shown to play a role, and Black, non-Hispanic women seem to be disproportionately affected. Public health policies that reflect the impact of structural racism on maternal health and health care in the United States are urgently needed.”

Dr. Huang emphasized, “The scientific community has produced clear evidence highlighting the critical importance of social determinants of health, including economic opportunities and accessible, affordable health insurance. Medicaid extension and expansion can go a long way in promoting health equity for everybody across the life course.”

Study Details:

The study analyzed 4,161 first-time mothers in their first trimester of pregnancy (67.3% white, 17% Hispanic, 15% Black). It used data from the nuMoM2b study (2010–2013) and its follow-up Heart Health Study (nuMoM2b-HHS, 2–7 years later).

Limitations: The study was observational and could not prove causation. Factors like hypertensive disorders and gestational diabetes, which may affect postpartum cardiovascular health, were not included in the analysis.

Funding and Disclosures: This research was partially funded by Dr. Huang’s American Heart Association Career Development Award. Additional details are available in the study abstract. Source: News Room